General Liability
The foundation Alaska hospitals, tribal health organisations and payers expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Alaska Home Care Insurance
For agencies already operating in Alaska. If a hospital, health system or payer has handed you a contract demanding limits your current policy cannot reach, that is a solvable problem, and it does not have to wait for your renewal date.
If you already run an Alaska home care agency
Here is the short answer. When a contract demands limits your policy cannot reach, the fix is general liability at the limit the contract names, professional liability sized to the care you deliver, an umbrella behind both, and certificates carrying the additional insured and waiver wording specified. We place that through exclusive carriers writing home care in Alaska, mid-term when the contract will not wait.
Two Alaska details are worth a look on an established program. The Division names family members and friends as employees who must still be covered, which closes off a reading owners rely on elsewhere. And we ask twice here where your policy was written, because a policy built around a different home state may not answer for work performed in Alaska.
An agency running seventy-five to a hundred caregivers across Anchorage, the Mat-Su, Fairbanks or the communities beyond the road system has a different problem from a startup, and this page is written for the former.
What Alaska contracts require, and what happens when yours falls short
On liability the numbers come from your contracts, and they ask more than the law does.
What the contracts typically ask for
Hospitals, health systems, tribal health organisations and payers usually require general liability at $1 million per occurrence and $2 million aggregate. Professional liability is expected of agencies delivering skilled care. Workers compensation at statutory limits with employers liability behind it. Auto liability for agency vehicles and caregivers driving their own. Abuse and molestation coverage, increasingly named rather than assumed. And an umbrella, which agencies working with the larger Anchorage institutions often need.
Wording matters as much as the number. Contracts routinely ask for additional insured status, a waiver of subrogation, primary and non-contributory response, and notice of cancellation. Each is an endorsement rather than a line on a certificate.
In an open market the numbers matter more, not less. Non-medical care here has no state facility licence, so a licence number does none of the quiet work it does elsewhere, and what a counterparty can actually check is the certificate you send.
When the contract asks for more than you carry
The first route is endorsement. The incumbent carrier will sometimes raise a limit or add required wording mid-term for extra premium, the fastest path where available.
The second is an umbrella. Where a contract wants a total your primary layers cannot reach, excess limits over general liability, auto and employers liability get there quicker and cheaper than rebuilding the primary.
The third is re-marketing, where a carrier will not extend or the wording sits outside the form. That takes longer, which is the argument for sending contract language when it appears rather than the week it must be signed.
Certificates of insurance and the rest of the operating year
For a running agency the broker relationship is mostly certificates and mid-term changes, and both are where a placement quietly fails.
Certificates
A certificate is evidence, not coverage; it states only what a policy does. If a Anchorage health system requires additional insured status and your policy carries no such endorsement, no certificate can create it. The delay agencies feel there is an underwriter deciding, not paperwork.
So the habit that helps: when a new client, facility or payer sends paperwork, send us the requirements immediately. Certificates on file should carry over rather than be rebuilt each year.
What to report during the year
Adding and removing caregivers does not need a policy change each time: the program is rated on payroll and headcount and trued up at audit. What needs reporting is a change in the agency's shape.
- A move onto the licensed home health track, which is a different unit, a different regime and a heavier professional liability picture.
- A new office, or clients in communities off the road system where getting there is a different mode of travel entirely.
- A family member or friend joining the payroll, since the Division names both as employees requiring coverage.
- A change of carrier or of the state your policy is written around.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- An acquisition, a new entity or a change of ownership, and any incident that could become a claim, reported when it happens rather than when it is served.
The payroll audit at the end of the term is worth preparing for. Records split properly by class keep it from producing a surprise premium.
Coverages Alaska home care agencies carry
The full program, sized to your status and how your people travel. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for licensed Alaska home health agencies, the track that sits under AS 47.32.
Professional liability coverageWorkers Compensation
Required of each employer having one or more employees in Alaska, with family members and friends expressly included.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through Anchorage winters and out along the road system.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, which a personal policy usually will not cover on a work trip.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations standard liability excludes, and in an open market one of the clearest signals you can give a client.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on your liability and auto, the efficient way to reach the totals larger Anchorage institutions require.
Umbrella liability coverageCyber Liability
Breach response for the protected health information your agency holds: notification, ransomware, regulatory defense.
Cyber liability coverageProperty and Business Owners Policy
Cover for the office, its contents, and business interruption after a loss.
Home care agency insuranceProvider types we insure in Alaska
Home Care Agencies
Non-medical agencies operating without a state facility licence, delivering personal care and companion work.
Home care agency insuranceHome Health Agencies
Licensed agencies under AS 47.32, delivering care under a plan of care and renewing every two years.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the work Alaska Medicaid funds through Personal Care Services.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 105,000 Alaska residents aged 65 and older.
Senior care coveragePrivate Duty Nursing
Skilled, high-acuity care that drives professional liability limits higher, often with an umbrella behind it.
Private duty nursing coverageGroup Home Care
Residential group homes combining a facility with hands-on care, carrying premises and property exposure.
Group home care coverageAlaska workers compensation for home care agencies
The Alaska Workers' Compensation Act requires each employer having one or more employees in Alaska to obtain workers' compensation insurance. That is the whole test. No headcount to reach, no payroll floor, no window while you are small.
Coverage is administered by the Alaska Department of Labor and Workforce Development, through its Division of Workers' Compensation. Alaska writes its carve-outs by work type rather than by employer size, and part-time baby-sitting appears among them, which is a different thing from a threshold and should not be read as one.
Family members and friends are named
This is the Alaska sentence worth reading twice, because most states leave it to inference. The Division states that all entities listed must still maintain workers' compensation coverage for employees, including family members and friends. Not implied. Named.
Home care agencies start small and personally more often than most businesses, and the habits persist as they grow. A spouse handling the schedule, a friend covering a weekend, an adult child stepping in when someone calls out. Owners routinely treat those as something other than employment, and here that reading is closed off in terms. If they work for the business, they belong on the policy. Read how the coverage works on our workers compensation page.
Owner exclusions, and the ownership floor most guidance omits
Exemptions took effect on 1 August 2019 for four categories: the sole proprietor of a sole proprietorship, partners in a partnership, members of a limited liability company with a minimum 10 percent ownership interest, and executive officers of for-profit corporations with a minimum 10 percent ownership interest.
Notice the 10 percent floor on the last two. Guidance written before August 2019 may not carry it, so a minority member or a titled officer with a small stake can assume an exemption that does not reach them. And whichever category applies, excluding an owner changes nothing for the caregivers on your schedule. It is a decision about one person.
Where your policy is written matters here
We ask every multi-state client where their policy was written and which states it names, and in Alaska we ask twice. An agency headquartered elsewhere that takes Alaska work, or an Alaska agency whose carrier built the policy around a different home state, should confirm the coverage actually answers for work performed here rather than assuming it travels. That conversation belongs before an injury, not after one, and it is the item on this page most likely to be wrong on an existing placement.
Alaska licensing and regulatory context
Short version, because you already hold what you hold. It earns space because Alaska splits its two sides of home care across two different parts of the Department of Health, and the difference is not cosmetic.
Home health agencies are licensed. The Department is explicit that HHAs are required to be licensed in the state of Alaska, under AS 47.32.010 through 900, through the Health Facilities Licensing and Certification Unit within the Division of Health Care Services, and health facility licences renew every two years.
Non-medical personal care has no equivalent state facility licence. The route instead is certification as a Medicaid Personal Care Assistance agency provider, handled by the Provider Certification and Compliance Unit within Senior and Disabilities Services, which also certifies home and community based services waiver providers. So an operator doing only non-medical work is certified, or not regulated at the state facility level at all, rather than licensed, and that language matters on a contract schedule.
It matters more for what it implies commercially. In a licensed state a licence number tells a hospital discharge planner, a family and a payer that somebody has inspected the operation. Alaska gives a non-medical agency no such shortcut, so what fills the gap is what you can show, and those documents are the credential rather than a compliance cost. On the skilled side, criminal background check regulations at 7 AAC 10.900 through 990 are cited as applying to licensed home health agencies, and a state that regulates screening that closely on one track is telling you what it worries about on both.
Medicaid, Medicare and what actually sets your limits
Alaska Medicaid funds in-home care through Personal Care Services, administered by the Division of Senior and Disabilities Services and delivered through private agencies. The Department also names Home and Community Based Services waivers and Community First Choice alongside it.
For a non-medical operator that programme is usually the difference between a private-pay book and a scalable one, and it is the reason PCA certification matters even though no licence does. It is also why the certification unit and the licensing unit sitting in different divisions is worth knowing: the people who decide whether you can bill are not the people who decide whether a home health agency can operate.
Medicare comes in separately, covering short-term skilled home health under a plan of care, which is the licensed track and the heavier professional liability exposure. What sets your limits is neither: it is the hospitals, health systems, tribal health organisations and payers you contract with. If your agency runs skilled care, our home health agency insurance page covers how that program is built. For the non-medical side, see personal care services.
The Alaska home care market
Alaska has about 740,000 residents, roughly 105,000 of them 65 or older. At about 14.8 percent of the civilian population that is the lowest share of any state we cover, so the demand story here is not the one that works elsewhere.
What defines the market is distance rather than demography. Alaska has only two metropolitan statistical areas in the entire state: Anchorage at about 407,000 and Fairbanks and College at about 95,000. Roughly 55 percent of the state population sits in the Anchorage metro, and everything else is spread across an enormous land area with limited road connection.
That last clause is the operating fact, and worth taking literally. In most states serving a rural client means a longer drive. In Alaska it can mean a different mode of travel altogether. A caregiver working Anchorage drives an ordinary metro route, where the exposure is accident frequency in traffic and winter. One serving a community off the road system is not driving further, they are travelling differently, and a program that assumes a car for every visit has misunderstood the book.
Agency-owned vehicles need commercial auto, and caregivers using their own cars create a hired and non-owned auto exposure a personal policy will not cover on a work trip. Alaska shares no border with another state, so the multi-state question here is about recruitment and ownership rather than caregivers crossing a line during a shift. If your organisation operates in other states, or your policy was written around one, your program still has to answer for work performed in Alaska. The full list of states we cover is on our coverage by state hub.
Alaska resources for home care providers
The sources behind everything above.
- Alaska DOH home health agency licensing, the licensed track under AS 47.32.
- Provider Certification and Compliance, Senior and Disabilities Services, which certifies PCA and waiver providers.
- Personal Care Services programme, the Medicaid route for in-home personal care.
- Division of Workers' Compensation and its employer requirements page.
- Alaska Hospital and Healthcare Association, a broad healthcare association whose membership includes home health agencies. We have not been able to confirm a home care specific trade association in Alaska.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Alaska agencies choose HCBI
We work with agencies already running, and their problems are contract problems.
A health system raises its limits at renewal. A payer adds abuse and molestation as a named requirement. A facility wants additional insured status and primary and non-contributory wording your form does not carry. A caregiver injured on a trip to a community off the road system tests a policy written for somewhere else. That is why we ask for the insurance exhibit rather than a summary.
On Alaska specifically, we ask where your policy was written and which states it names, and we ask twice, because an agency headquartered elsewhere taking Alaska work, or one whose carrier built the policy around a different home state, needs the coverage to answer for work performed here. We also take the Division at its word that family members and friends must be covered, which is named here rather than left to inference.
We place coverage through exclusive carrier programs that write home care risks, and we coordinate the whole program: general liability, professional liability, workers compensation, commercial and hired and non-owned auto built for how your people actually travel, umbrella limits to reach what your contracts demand, cyber, and abuse and molestation coverage of up to $1 million. That reach is backed by relationships across the home care and healthcare industry, including CareerStaff Unlimited and Genesis Healthcare in staffing, HOMELINK in medical equipment and home care networks, and Bright Horizons Family Solutions on the family care side.
Alaska home care insurance FAQ
Answers for agencies operating under Alaska rules.
Usually, and usually before renewal. The underlying general liability limit can sometimes be raised by endorsement. More often an umbrella stacked over general liability, auto and employers liability reaches the required total faster and for less than rebuilding the primary program. Where the carrier will not extend, the program is re-marketed. Send us the insurance exhibit rather than a summary; the wording matters as much as the number.
The certificate is quick. What takes time is anything it must evidence that your policy does not yet do: additional insured status, a waiver of subrogation, primary and non-contributory wording, or a notice of cancellation. Those are endorsements, not lines typed onto a form. Send us contract wording when it first arrives, not on the day the certificate is due.
Not person by person. The program is rated on payroll and headcount estimates and trued up at audit, so ordinary turnover needs no policy change. What does need reporting is a change in what the agency does: a move onto the licensed home health track, a new office or territory, a family member or friend joining the payroll, agency-owned vehicles, or a change of carrier.
Yes, from the first employee. The Alaska Workers' Compensation Act requires each employer having one or more employees in Alaska to obtain workers' compensation insurance, and that is the whole test: no headcount to reach, no payroll floor, no window while you are small. It is administered by the Alaska Department of Labor and Workforce Development through its Division of Workers' Compensation. Alaska writes its carve-outs by work type rather than by employer size, and part-time baby-sitting appears among them, which is a different thing from a threshold and should not be read as one.
Yes, and Alaska names them rather than leaving it to inference. The Division states that all entities listed must still maintain workers' compensation coverage for employees, including family members and friends. Home care agencies start small and personally more often than most businesses, and the habits persist: a spouse handling the schedule, a friend covering a weekend, an adult child stepping in when someone calls out. Owners routinely treat those arrangements as something other than employment, and here that reading is closed off in terms. If they work for the business, they belong on the policy.
Some can, subject to an ownership floor that older guidance often omits. Exemptions took effect on 1 August 2019 for four categories: the sole proprietor of a sole proprietorship, partners in a partnership, members of a limited liability company with a minimum 10 percent ownership interest, and executive officers of for-profit corporations with a minimum 10 percent ownership interest. Notice the 10 percent floor on the last two, because a minority member or a titled officer with a small stake can assume an exemption that does not reach them. Whichever applies, excluding an owner changes nothing for the caregivers on your schedule.
That is the question to settle before an injury rather than after one, and it is the item most likely to be wrong on an existing Alaska placement. We ask every multi-state client where their policy was written and which states it names, and in Alaska we ask twice. An agency headquartered elsewhere that takes Alaska work, or an Alaska agency whose carrier built the policy around a different home state, should confirm the coverage actually answers for work performed here rather than assuming it travels. Alaska shares no border with another state, so the multi-state question is about recruitment and ownership rather than caregivers crossing a line during a shift.
Loss runs for the last five years, declarations pages for every line, payroll by class, caregiver headcount, the counties you serve, and the exhibits from your largest contracts. Start sixty to ninety days out. A non-renewal shortens the carrier list, and lead time buys the options back.
Send us the contract and we will build to it
Tell us your payroll and caregiver count, how your caregivers actually reach clients, and which states your current policy names, and what your largest contract requires. If a limit needs raising before your renewal date, say so and we will start there. A specialist will build the program through exclusive carriers that write home care in Alaska. There is no obligation.